Bioethics and hospital palliative care: a systematic review

The finitude of life presents various bioethical challenges, especially when palliative care is the therapeutic option. The hospital environment for palliative care has ethical peculiarities that need to be better understood, since the literature presents research that is commonly carried out at home.

This study aims to investigate the fundamental bioethical perspectives for hospital palliative care and to compare these perspectives with those existing in home care.

A systematic review of the literature was conducted between March and April 2024. This included observational studies that addressed bioethical perspectives in hospital palliative care. No restrictions were placed on the date of publication or language of the article. This review excluded editorials, intervention studies and articles developed in a home environment.

Seven databases and other sources were searched, and 3976 articles were found. Eight studies were selected for qualitative synthesis. A paired review was conducted at all stages. The results indicated that respect for cultural beliefs and values, effective communication and empathy were the most significant bioethical perspectives for hospital palliative care, among the nine other ethical aspects present in the studies. The comparison with bioethical perspectives in the home environment highlighted differences such as privacy and autonomy in the patient's home.

The conclusion allows us to understand that aspects of caring for the person and understanding the illness should be the focus of bioethics in hospital palliative care.